Macrolides and ketolides

Question 1

mechanism of action

Answer 1

irreversibly bind to 50S subunit
inhibits translocation steps of protein sysnthesis

Question 2

Bacteriostatic or Bacteriocidal?

Answer 2

Bacteriostatic and at higher doses it is bacteriocidal

Question 3

Uses of erythromycin

Answer 3

penicillin G substitute
pertussis
community acquired pneumonia
DOC in chlaymedia for pregnant woman
CORYNEBACTERIUM DIPTHERIA

Question 4

uses of clarithromycin

Answer 4

same as eryhtro but also for
Chlaymedia
legionalla
moraxella
H pylori

Question 5

USES OF azithromycin

Answer 5

less active than erythro against strep and staph–
more active against h influenza, moraxella catarhalsis,
Urethritis
LEGIONELLOSIS
MYCOPLASMA PNEUMONIA
(ATYPICAL)
CHLAYMIDIA
MYCOBACTERIUM AVIUM COMPLEX

Question 6

telithromycin

Answer 6

spectrum similar to azithromycin
neutralizes all resistance mechanism

Question 7

resistance

Answer 7

efflux pump
dec affinity to 50S ribosome
plasmid assoc erythromycin esterase

Question 8

route of adm

Answer 8

ORAL
ERYTHRO AND AZITHROMYCIN ARE AFFECTED BY FOOD

Question 9

What is the effect of gastric fluid on erythromycin

Answer 9

Destroyed so has to be enteric coated or esterified

Question 10

what is the ketolide?

Answer 10

telithromycin

Question 11

which drugs in this class inhibit CYP450

Answer 11

erythromycin and telithromycin

Question 12

Which macrolide causes senso neural hearing loss?

Answer 12

Azithromycin

Question 13

which macrolide is more ototoxic

Answer 13

erythromycin

Question 14

Which macrolide causes cholestatic jaundice?

Answer 14

erythromycin(occurs with estolate form of erythromycin)

Question 15

what other form of adr is casued by maacrolides?

Answer 15

GI DISTRESS (less with azithro)

Question 16

contra indication—

Answer 16

hepatic dysfunction
pts with proarrythmic conditions